LymphedemaV1, Main, Exploration, bibRecord, 001170

Dosimetric evaluation of incidental irradiation to the axilla during whole breast radiotherapy for patients with left-sided early breast cancer in the IMRT era

Identifieur interne : 001170 ( Main/Exploration ); précédent : 001169; suivant : 001171

Dosimetric evaluation of incidental irradiation to the axilla during whole breast radiotherapy for patients with left-sided early breast cancer in the IMRT era

Auteurs : Jayoung Lee [Corée du Sud] ; Shin-Wook Kim [Corée du Sud] ; Seok Hyun Son [Corée du Sud]

Source :

Medicine [ 0025-7974 ] ; 2016.

RBID : PMC:4937944

Abstract

The purpose of this study was to compare the dosimetric parameters for incidental irradiation to the axilla during whole breast radiotherapy (WBRT) with 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). Twenty left breast cancer patients treated with WBRT after breast-conserving surgery (BCS) were enrolled in this study. Remnant breast tissue, 3 levels of the axilla, heart, and lung were delineated. We used 2 different radiotherapy methods: 3D-CRT with field-in-field technique and 7-field fixed-beam IMRT. The target coverage of IMRT was significantly better than that of 3D-CRT (D_mean: 49.72 ± 0.64 Gy vs 50.24 ± 0.66 Gy, P < 0.001; V₄₅: 93.19 ± 1.40% vs 98.59 ± 0.30%, P < 0.001; V_47.5: 86.43 ± 2.72% vs 95.00 ± 0.02%, P < 0.001, for 3D-CRT and IMRT, respectively). In the IMRT plan, a lower dose was delivered to a wider region of the heart and lung. Significantly lower axillary irradiation was shown throughout each level of axilla by IMRT compared to 3D-CRT (D_mean for level I: 42.58 ± 5.31 Gy vs 14.49 ± 6.91 Gy, P < 0.001; D_mean for level II: 26.25 ± 10.43 Gy vs 3.41 ± 3.11 Gy, P < 0.001; D_mean for level III: 6.26 ± 4.69 Gy vs 1.16 ± 0.51 Gy, P < 0.001; D_mean for total axilla: 33.9 ± 6.89 Gy vs 9.96 ± 5.21 Gy, P < 0.001, for 3D-CRT and IMRT, respectively). In conclusion, the incidental dose delivered to the axilla was significantly lower for IMRT compared to 3D-CRT. Therefore, IMRT, which only includes the breast parenchyma, should be cautiously used in patients with limited positive sentinel lymph nodes and who do not undergo complete axillary lymph node dissection.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937944

DOI: 10.1097/MD.0000000000004036
PubMed: 27368030
PubMed Central: 4937944

Affiliations:

Le document en format XML

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<author><name sortKey="Lee, Jayoung" sort="Lee, Jayoung" uniqKey="Lee J" first="Jayoung" last="Lee">Jayoung Lee</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Department of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea</nlm:aff>
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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<p>The purpose of this study was to compare the dosimetric parameters for incidental irradiation to the axilla during whole breast radiotherapy (WBRT) with 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). Twenty left breast cancer patients treated with WBRT after breast-conserving surgery (BCS) were enrolled in this study. Remnant breast tissue, 3 levels of the axilla, heart, and lung were delineated. We used 2 different radiotherapy methods: 3D-CRT with field-in-field technique and 7-field fixed-beam IMRT. The target coverage of IMRT was significantly better than that of 3D-CRT (<italic>D</italic>
<sub>mean</sub>
: 49.72 ± 0.64 Gy vs 50.24 ± 0.66 Gy, <italic>P</italic>
 < 0.001; <italic>V</italic>
<sub>45</sub>
: 93.19 ± 1.40% vs 98.59 ± 0.30%, <italic>P</italic>
 < 0.001; <italic>V</italic>
<sub>47.5</sub>
: 86.43 ± 2.72% vs 95.00 ± 0.02%, <italic>P</italic>
 < 0.001, for 3D-CRT and IMRT, respectively). In the IMRT plan, a lower dose was delivered to a wider region of the heart and lung. Significantly lower axillary irradiation was shown throughout each level of axilla by IMRT compared to 3D-CRT (<italic>D</italic>
<sub>mean</sub>
 for level I: 42.58 ± 5.31 Gy vs 14.49 ± 6.91 Gy, <italic>P</italic>
 < 0.001; <italic>D</italic>
<sub>mean</sub>
 for level II: 26.25 ± 10.43 Gy vs 3.41 ± 3.11 Gy, <italic>P</italic>
 < 0.001; <italic>D</italic>
<sub>mean</sub>
 for level III: 6.26 ± 4.69 Gy vs 1.16 ± 0.51 Gy, <italic>P</italic>
 < 0.001; <italic>D</italic>
<sub>mean</sub>
 for total axilla: 33.9 ± 6.89 Gy vs 9.96 ± 5.21 Gy, <italic>P</italic>
 < 0.001, for 3D-CRT and IMRT, respectively). In conclusion, the incidental dose delivered to the axilla was significantly lower for IMRT compared to 3D-CRT. Therefore, IMRT, which only includes the breast parenchyma, should be cautiously used in patients with limited positive sentinel lymph nodes and who do not undergo complete axillary lymph node dissection.</p>
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Dosimetric evaluation of incidental irradiation to the axilla during whole breast radiotherapy for patients with left-sided early breast cancer in the IMRT era

Dosimetric evaluation of incidental irradiation to the axilla during whole breast radiotherapy for patients with left-sided early breast cancer in the IMRT era

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Abstract

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